scholarly journals Perspectives of Health Service Providers on Barriers to Accessing Perinatal Mental Health Services in Karnataka, India: a Qualitative Study

Author(s):  
Debarati Mukherjee ◽  
Nolita Dolcy ◽  
Daisy A John ◽  
Maithili Karthik ◽  
Swapnil A Gadhave ◽  
...  

Abstract Background: Poor maternal mental health is a major public health concern since it adversely impacts both maternal and child health outcomes. This study aimed to document the barriers to utilizing perinatal mental health services in Karnataka, India, and to determine its relationship with risk factors of poor maternal mental health in this context. Methods: Qualitative research methods using in-depth interviews were conducted on twenty-one local stakeholders who represented health service providers in various capacities: mental health specialists (n = 4), gynaecologists (n = 2), government officials from the Department of Health and Family Welfare (n = 2), and Department of Women and Child Development (n = 2), senior state consultant to United Nations Children’s Fund (n = 1), and frontline workers (n = 10). Data were analysed using a thematic framework analysis approach. Results: We identified multiple barriers to service utilization operating at the levels of the health system, community, family, and the individual. Health-system level barriers included lack of a universal screening mechanism, poor infrastructure, poor training of frontline workers on mental health issues, and inadequate time for counselling and treatment. Community-level barriers included stigma and misconceptions, leading to a lack of social support. Family and individual level barriers included the financial burden of availing services, lack of family and partner support, and lack of empowerment and motivation in the woman to seek services. Family and individual level barriers interacted with risk factors of poor maternal mental health. Based on this evidence and drawing from the literature, we propose a contextualised, stepped-care model for universal screening, detection, referral, and treatment of women with perinatal mental health conditions for Karnataka that is integrated with the reproductive, maternal, and child health (RMNCH) program in primary care settings. Conclusions: The framework developed in this study suggests that addressing the identified barriers would potentially increase uptake of available services, create awareness about and demand for high-quality mental health services, reduce the risk factors of poor maternal mental health, and eventually improve our understanding of its true burden in the state of Karnataka. This is essential for proper implementation, monitoring, and evaluation of programs relevant to perinatal mental health.

2021 ◽  
Author(s):  
Debarati Mukherjee ◽  
Nolita Dolcy ◽  
Daisy A John ◽  
Maithili Karthik ◽  
Swapnil A Gadhave ◽  
...  

Abstract Background: Poor maternal mental health is a major public health concern since it adversely impacts both maternal and child health outcomes. This study aimed to document the barriers to utilizing perinatal mental health services in Karnataka, India, and to determine its relationship with risk factors of poor maternal mental health in this context. Methods: Qualitative research methods using in-depth interviews were conducted on twenty-one local stakeholders who represented health service providers in various capacities: mental health specialists (n = 4), gynaecologists (n = 2), government officials from the Department of Health and Family Welfare (n = 2), and Department of Women and Child Development (n = 2), senior state consultant to United Nations Children’s Fund (n = 1), and frontline workers (n = 10). Data were analysed using a thematic framework analysis approach. Results: We identified multiple barriers to service utilization operating at the levels of the health system, community, family, and the individual. Health-system level barriers included lack of a universal screening mechanism, poor infrastructure, poor training of frontline workers on mental health issues, and inadequate time for counselling and treatment. Community-level barriers included stigma and misconceptions, leading to a lack of social support. Family and individual level barriers included the financial burden of availing services, lack of family and partner support, and lack of empowerment and motivation in the woman to seek services. Family and individual level barriers interacted with risk factors of poor maternal mental health. Based on this evidence and drawing from the literature, we propose a contextualised, stepped-care model for universal screening, detection, referral, and treatment of women with perinatal mental health conditions for Karnataka that is integrated with the reproductive, maternal, and child health (RMNCH) program in primary care settings. Conclusions: The framework developed in this study suggests that addressing the identified barriers would potentially increase uptake of available services, create awareness about and demand for high-quality mental health services, reduce the risk factors of poor maternal mental health, and eventually improve our understanding of its true burden in the state of Karnataka. This is essential for proper implementation, monitoring, and evaluation of programs relevant to perinatal mental health.


2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.


2007 ◽  
Vol 31 (4) ◽  
pp. 623 ◽  
Author(s):  
Tom J Meehan ◽  
Terry J Stedman ◽  
Ken E Neuendorf ◽  
Irene D Francisco ◽  
Malcolm G Neilson

Background: Benchmarking of performance indicators in the mental health field is gaining currency in Australia as a strategy for improving service quality. Aim: To engage mental health service providers in the collection and evaluation of performance data. Methods: Three separate rounds of data collection involving high secure, extended treatment, and medium secure services were carried out between 2003 and 2005. Twenty-five core indicators were identified and these were used to assess service inputs, processes, outputs and outcomes. Results: Differences in casemix, clinical practice and local business rules gave rise to variation in service performance. The benchmarking exercise led to the implementation of quality improvement initiatives. Conclusions: It is possible and useful to collect and evaluate performance data for mental health services. While services appear similar enough to benchmark, information related to both casemix and service characteristics needs to be included in benchmarking data to understand the factors that produce differences in service performance.


Author(s):  
Joe Behler ◽  
Allen Daniels ◽  
Jennifer Scott ◽  
Lewis Mehl-Madrona

Peer support services remain poorly understood by many mental health service providers. In this study we explored the views of people who use peer led support groups. We asked how adding peer support groups changed, balanced, or augmented the use of conventional mental health services. Participants were 43 adults attending 4 peer led support groups for depression/bipolar disorder. Data consisted of observations of all 43 participants interacting in their group, in-depth interviews of 20 participants, and results from 2 standardized questionnaires to ballpark the level of symptom severity relative to other groups. Through constant comparative analysis, 12 categories emerged. The most salient features of our findings consisted of the shared perception that groups promoted recovery and augmented conventional services. Members felt acceptance due to their shared diagnoses. Groups provided an experience of community in which recovery skills could be practiced, practical advice received, and hope and empowerment encouraged. Groups appeared to provide participants with important support and healing unavailable from psychotherapy and psychiatry. Peer support groups appeared to be an important addition and sometimes an adequate substitute for psychotherapy and/or psychiatry. Further research is indicated and quantitative students should build on the insights of qualitative studies in developing their protocols.


2015 ◽  
Vol 46 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Wendy A. Coduti ◽  
Melissa Manninen Luse

Individuals living in rural areas have similar prevalence rates of mental health conditions as individuals living in urban areas, yet face a number of challenges in accessing and receiving proper mental health services. For mental health service providers there are unique ethical challenges when working in rural areas. This paper will examine aspects of rural living, and ethical issues surrounding provision of mental health services. Implications for practice and research are assessed for rehabilitation counselors working in these settings.


2012 ◽  
Vol 18 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Mike Slade

SummaryRoutine use of Health of the Nation Outcome Scales (HoNOS) has not produced the anticipated benefits for people using mental health services. Four HoNOS-specific reasons for this are: low relevance to clinical decision-making; not reflecting service user priorities; being staff-rated; and having a focus on deficits. More generally, the imposition of a centrally chosen measure on the mental health system leads to a clash of cultures, since frontline workers do not need a standardised measure to treat individuals. A better approach might be to use research from the emerging academic discipline of implementation science to inform the routine use of a standardised measure that is chosen by the people who will use it and hence is more concordant with existing clinical processes. This is illustrated using a case study of successful implementation of the Camberwell Assessment of Need (CAN) in community mental health services across Ontario, Canada.


2021 ◽  
Vol 43 (5) ◽  
pp. 661-662
Author(s):  
Lesley Tarasoff ◽  
Christine Ou ◽  
Amanda Hooykaas ◽  
Jaime Charlebois ◽  
Lianne Tomfohr-Madsen ◽  
...  

2000 ◽  
Vol 51 (2) ◽  
pp. 203-209 ◽  
Author(s):  
Verinder Sharma ◽  
Diane Whitney ◽  
Shahé S. Kazarian ◽  
Rahul Manchanda

2016 ◽  
Vol 33 (S1) ◽  
pp. S58-S59 ◽  
Author(s):  
H. Tuomainen ◽  
S.P. Singh ◽  

IntroductionCurrent service configuration of distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS) is considered the weakest link where the care pathway should be most robust. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge for the EU.ObjectivesThe overall objective of the MILESTONE project is to improve transition from CAMHS to AMHS in diverse healthcare settings in Europe.AimsTo improve the understanding of current transition-related service characteristics, and processes, outcomes and experiences of transition from CAMHS to AMHS using a bespoke suite of measures; to explore the ethical challenges of providing appropriate care to young people as they move to adulthood; to test a model of managed transition in a cluster randomized controlled trial (cRCT) for improving health, social outcomes and transition to adult roles; and to develop training modules for clinicians and policy guidelines.MethodsData will be collected via systematic literature reviews; bespoke surveys to CAMHS professionals, experts and other stakeholders; focus groups with service providers and users and members of youth and mental health advocacy groups; and a longitudinal cohort study with a nested cRCT in eight EU countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS service users, their parents/carers, and clinicians, with assessments at baseline, 9, 18 and 27 months.ResultsFirst results are expected in 2016 with further major findings following in 2019.ConclusionsThe MILESTONE project will provide unprecedented information on the nature and magnitude of problems at the CAMHS-AMHS interface, and potential solutions to overcome these.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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